92 Decision Citation: BVA 92-12730
Y92
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 91-45 671 ) DATE
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THE ISSUES
1. Entitlement to an increased evaluation for
schizophrenia, paranoid type, rated as 30 percent
disabling.
2. Entitlement to a total evaluation based on individual
unemployability due to the service-connected psychiatric
disability.
REPRESENTATION
Appellant represented by: Veterans of Foreign Wars of the
United States
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
Ronald R. Bosch, Counsel
INTRODUCTION
This matter came before the Board of Veterans' Appeals
(Board) on appeal from rating decisions of the Chicago,
Illinois, Regional Office (hereinafter RO). The appellant
is a Vietnam Era veteran. A May 1989 rating decision
continued the 10 percent evaluation for his paranoid
schizophrenia. The notice of disagreement for the above
determination was received on July 3, 1989. An August 1989
rating decision increased the evaluation for paranoid
schizophrenia from 10 percent to 30 percent disabling. The
notice of disagreement for the above determination was
received on October 31, 1989. The statement of the case was
issued on November 20, 1989. The substantive appeal was
received on January 18, 1990. A hearing was held before a
hearing officer at the RO in February 1990. In a July 1990
decision, the hearing officer continued the 30 percent
evaluation for paranoid schizophrenia. A supplemental
statement of the case was issued on October 23, 1990.
Rating decisions by the RO in January and April 1991
continued the 30 percent evaluation for paranoid
schizophrenia. A supplemental statement of the case was
issued on July 26, 1991. The case was received and docketed
at the Board in October 1991. The case was referred to the
Veterans of Foreign Wars of the United States in October
1991 and they submitted written argument on the veteran's
behalf in February 1992.
We have construed the issues for appellate consideration as
reported on the title page in view of our statutory duty to
assist the veteran which includes consideration of issues
raised in all documents or oral testimony submitted prior to
our decision, and not just those derived from a liberal
reading of the appellant's substantive appeal. Myers v.
Derwinski, U.S. Vet. App. No. 90-221 (January 18, 1991) and
EF v. Derwinski, U.S. Vet. App. No. 91-533 (June 21, 1991).
REMAND
A review of the record discloses that the veteran underwent
special psychiatric examinations by the VA in April and July
1989. Those examinations are somewhat dated for the purpose
of considering the current severity of paranoid
schizophrenia. The record shows that the veteran continues
to receive psychotherapy on an outpatient basis by the VA,
the complete records of which are not on file.
The VA has a duty to assist the veteran in the development
of facts pertinent to his claim. 38 U.S.C. § 5107(a)
(1991); 38 C.F.R. § 3.103(a) (1991). The United States
Court of Veterans Appeals has held that the duty to assist
the veteran in obtaining and developing available facts and
evidence to support his claim includes obtaining medical
records to which the veteran has referred and obtaining
adequate VA examinations. Littke v. Derwinski, U.S. Vet.
App. No. 89-68 (December 6, 1990). This duty includes
additional VA examination by a specialist, when recommended
or indicated. Hyder v. Derwinski, U.S. Vet. App. No. 90-254
(April 15, 1991). Under the circumstances of this case, we
are of the opinion that additional assistance is required.
The case is REMANDED to the agency of original jurisdiction
for the following:
1. Certified copies of the complete
medical records pertaining to treatment
of the veteran at the VA West Side
Medical Center, Chicago, Illinois, should
be obtained and associated with the
claims file.
2. A social and industrial survey should
be conducted. Any vocational
rehabilitation folder should be obtained
and made part of the record.
3. After this, the veteran should
undergo a special psychiatric examination
by the VA for the purpose of ascertaining
the severity of his paranoid
schizophrenia. Any indicated special
studies should be undertaken. The
examiners should discuss the affect of
the psychiatric disability on the
veteran's ability to work. The report of
examination should include a detailed
account of all manifestations of
psychiatric disease found to be present
and a complete rationale for all
conclusions reached. The claims file,
together with evidence obtained
pertaining to the foregoing request,
should be made available to and reviewed
by the examiner prior to the
examination.
Following completion of these actions, the agency of
original jurisdiction should review the evidence and
determine whether the veteran's claims may now be granted.
If not, the veteran and his representative should be
provided with an appropriate supplemental statement of the
case which includes 38 C.F.R. § 4.16 and, in view of
Schafrath v. Derwinski, U.S. Vet. App. No. 89-114
(November 26, 1991), which includes consideration and
application of 38 C.F.R. 4.1, 4.2, 4.41, 4.42 and any other
pertinent provisions of the VA Schedule for Rating
Disabilities with a view toward discussion of the history of
paranoid schizophrenia. They should be afforded an
opportunity to respond. The case should then be returned to
the Board for further appellate consideration.
The purpose of this REMAND is to obtain clarifying
evidence. No action is required by the veteran until he
receives further notice.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
W. H. YEAGER, JR., M.D. JAN DONSBACH
JOAQUIN AGUAYO-PERELES
Under 38 U.S.C. § 7252 (1992), only a decision of the Board
of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of
a preliminary order and does not constitute a decision of
the Board on the merits of your appeal.